OBJECTIVEThe aim of this study was to investigate the value of free anterolateral thigh myocutaneous flap (ALTMF) and computed tomography angiography (CTA) for the reconstruction of mouth-floor defects after the resection of middle-late stage carcinoma of the mouth floor.

METHODSSixteen cases of middle-late stage carcinomas of the mouth floor underwent radical resection, and mouth-floor and tongue defects were reconstructed with ALTMF. CTA was applied to plan the lateral circumflex femoral artery (LCFA) and its perforating vessel, which was verified during the operation.

RESULTSThe position of the perforating vessel in the operation was fully consistent with that designed by the preoperative CTA. All 16 flaps completely survived. The appearance and function of all cases were both satisfactory. All donor sites were primarily closed and healed without functional morbidity. During the follow-up period of 6-36 months, 15 cases survived with acceptable aesthetic and functional results in mouth floor and tongue reconstruction, except for 1 case (T4N2M0) that died of metastasis carcinoma 10 months after operation.

CONCLUSIONCTA can accurately locate the LCFA and artery perforator. Preoperative perforator planning using CTA in ALTMF transplantation is a reliable and useful method thatresults in safe operation with optimal outcome. The ALTMF is an ideal choice for the reconstruction of soft tissue defects after the resection of middle-late staie carcinoma of the mouth floor

Angiography ; Carcinoma ; Free Tissue Flaps ; Humans ; Mouth Floor ; Myocutaneous Flap ; Patient Care Planning ; Reconstructive Surgical Procedures ; Thigh ; Tomography ; Tongue

AIM: To study the effect of mesenchymal stem cells (MSCs) infusion on hematopoietic recovery after peripheral blood stem cell transplantation in mice. METHODS: BALB/c mice conditioned by high dose chemotherapy/radiotherapy were infused with 10 6 peripheral blood mononuclear cells (PBMC) mobilized by granulocyte colony-stimulating factor (PBSCT group), 10 4 MSCs culture-expanded in vitro and 10 6 PBMC(experimental group 1), 10 6 MSCs and 10 6 PBMC(experimental gruop 2). Survival rate within 4 weeks, white blood cell count, bone marrow nucleated cells (BMNC), granulocyte-macrophage colony forming unit(GM-CFU) and fibroblast colony forming unit (F-CFU) were examined. RESULTS: Survival rate, BMNC, GM-CFU, F-CFU were significantly higher in experimental group 2 than that in PBSCT group ( P

Objective To observe the clinical effect of Yanshu compound radix sophore injection combined with radiotherapy in treatment of patients with bone metastases from lung cancer. Methods A total of 116 patients with bone metastases from lung cancer admitted to the Department of Radiation Oncology of Gansu Provincial Cancer Hospital from January 2014 to December 2018 were selected. The 58 patients were treated by using three-dimensional conformal radiotherapy (3D-CRT), zoledronic acid and oxycodone sustained-release tablets (control group); the others 58 patients were treated radix sphore injection on basis of control group (integrated Chinese and western medicine). The two groups were treated continuously for 10 days as 1 course of treatment, taking a rest for one week in the middle, then they took the second course of treatment; after the end of 2 courses, the therapeutic effects were evaluated in the two groups. The pain grading, Karnofsky functional status (KPS) score and myelosuppression were observed before and after treatment in two groups, respectively. Results The proportions of patients with painless and mild pain after treatment in the integrated Chinese and western medicine group were significantly lower than those in control group [painless: 22.41% (13/58) vs. 39.66% (23/58), mild pain: 10.35% (6/58) vs. 46.55% (27/58)], while the proportions of patients with moderate pain and severe pain in the integrated Chinese and western medicine group were significantly higher than those of the control group [moderate pain: 53.45(31/58) vs. 12.07% (7/58), severe pain: 13.79% (8/58) vs 1.72% (1/58), both P < 0.05]. After treatment, the proportion of patients with improved KPS score in integrated Chinese and western medicine group was significantly higher than that in control group [55.17% (32/58) vs. 36.21% (21/58), P < 0.05], and the proportion of patients with stable and decreased KPS score were less than that of control group [stable KPS score:18.97%(11/58) vs. 27.59%(16/58), decreased KPS score:25.86% (15/58) vs. 36.21% (21/58)]. The proportions of patients with blood cell count (WBC), hemoglobin (Hb) and platelet count (PLT) showing no myelosuppression (at the zero degree) after treatment in integrated Chinese and western medicine group were obviously higher than those in control group [WBC: 77.59% (45/58) vs. 36.21% (21/58), Hb: 77.59% (45/58) vs. 70.69% (41/58), PLT: 58.62% (34/58) vs. 32.76% (19/58), all P < 0.05]. Conclusion Yanshu compound radix sphore injection combined with radiotherapy can reudce bone metastasis pain, reduce bone marrow suppression and improve quality of life in patients with advanced lung cancer and bone metastasis.

Objective The?aim?of?this?study?was?to?investigate?the?value?of?free?anterolateral?thigh?myocutaneous?flap?(ALTMF)?and?computed?tomography?angiography?(CTA)?for?the?reconstruction?of?mouth-floor?defects?after?the?resection?of?middle-late?stage?carcinoma?of?the?mouth?floor.?Methods???Sixteen?cases?of?middle-late?stage?carcinomas?of?the?mouth?floor?underwent?radical?resection,?and?mouth-floor?and?tongue?defects?were?reconstructed?with?ALTMF.?CTA?was?applied?to?plan?the?lateral?circumflex?femoral?artery?(LCFA)?and?its?perforating?vessel,?which?was?verified?during?the?operation.?Results???The?position?of?the?perforating?vessel?in?the?operation?was?fully?consistent?with?that?designed?by?the?preoperative?CTA.?All?16?flaps?completely?survived.?The?appearance?and?function?of?all?cases?were?both?satisfactory.?All?donor?sites?were?primarily?closed?and?healed?without?functional?morbidity.?During?the?follow-up?period?of?6–36?months,?15?cases?survived?with?acceptable?aesthetic?and?functional?results?in?mouth?floor?and?tongue?reconstruction,?except?for?1?case?(T4N2M0)?that?died?of?metastasis?carcinoma?10?months?after?operation.?Conclusion???CTA?can?accurately?locate?the?LCFA?and?artery?perforator.?Preoperative?perforator?planning?using?CTA?in?ALTMF?transplantation?is?a?reliable?and?useful?method?thatresults?in?safe?operation?with?optimal?outcome.?The?ALTMF?is?an?ideal?choice?for?the?reconstruction?of?soft?tissue?defects?after?the?resection?of?middle-late?stage?carcinoma?of?the?mouth?floor.

Objective:To evaluate the clinical applicability of CT angiography (CTA) for locating the perforator vessels of anterolateral thigh flap(ALTF) and the effects of individualized ALTF designed by CTA for the reconstruction of the soft tissue defects of tongue after the resection of tongue carcinoma.Methods:21 patients with tongue squamous cell carcinoma underwent CTA for locating the perforator vessels of ALTFs and for the design of individualized ALTFs before operation.The patients underwent soft tissue defect reconstruction with individualized ALTFs after tumor removal.Results:All the operations came off as preoperative designed,the intraoperative findings of the blood vessel alignment were consistent with the preoperative CTA results.The size of flaps was 6.0 cm × 5.0 cm-11.0 cm× 8.5 cm.20 ALTFs survived,2 ALTFs appeared vascular crisis,1 remained survival and the other was necrotic after surgical exploration.During 6 ～ 60 momhs of follow-up,the survival condition of flaps and the wound healing condition were both satisfactory.1 patient died because of distant metastasis 18 months after operation.20 patients reminded free of carcinoma and satisfied with the reconstructive effects of chewing,swallowing and linguistic function.Conclusion:CTA can accurately locate perforator vessels for the design of individualized AFLT.AFLT designed by CTA is an ideal choice for the reconstruction of postoperative soft tissue defects after resection tongue carcinoma.

Objective To evaluate the risk factors and sonographic findings of pregnancies complicated by placenta increta or placenta percreta. Methods Totally, 2219 cases were retrospectively analyzed from 20 tertiary hospitals in China from January 2011 to December 2015. The data were collected based on the original case records. All cases were divided into two groups, the placenta increta (PI) group (79.1％, 1755/2219) and the placenta percreta (PP) group (20.9％, 464/2219), according to the degree of placental implantation. The risk factors and sonographic findings of placenta increta or percreta were analyzed by uni-factor and logistic regression statistic methods. Results The risk factors associated with the degree of placental implantation were age, gravida, previous abortion or miscarriage, previous cesarean sections, and placenta previa (all P<0.05), especially, previous cesarean sections (χ2=157.961) and placenta previa (χ2=91.759). Sonographic findings could be used to predict the degree of placental invasion especially the boundaries between placenta and uterine serosa, the boundary between placenta and myometrium, the disruption of the placental-uterine wall interface and loss of the normal retroplacental hypoechoic zone(all P<0.01). Conclusions Previous cesarean sections and placenta previa are the main independent risk factors associated with the degree of placenta implantation. Ultrasound could be used to make a prenatal suggestive diagnosis of placenta accreta spectrum disorders.